Provider Demographics
NPI:1346688280
Name:GEORGE, SHEILA DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:DAWN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 COUNTY ROAD 1067
Mailing Address - Street 2:
Mailing Address - City:AUXVASSE
Mailing Address - State:MO
Mailing Address - Zip Code:65231-3113
Mailing Address - Country:US
Mailing Address - Phone:573-424-1418
Mailing Address - Fax:
Practice Address - Street 1:868 COUNTY ROAD 1067
Practice Address - Street 2:
Practice Address - City:AUXVASSE
Practice Address - State:MO
Practice Address - Zip Code:65231-3113
Practice Address - Country:US
Practice Address - Phone:573-424-1418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor